Adapted Physical Activity: Impairments

• Adapted Physical Activity Impairment Cheat Sheet from February 12, 2025

Physical Impairment

• Surgical amputation is defined as the surgical removal of an appendage as a result of damage.
• Phacomelia refers to abnormal development or underdeveloped limbs.
• Arthritis is characterized by painful inflammation and stiffness in the joints.
• Osteoporosis is when bones become brittle and fragile due to tissue loss, commonly from hormonal changes, or calcium or Vitamin D deficiency.
• Dwarfism causes people to have an unusually short stature and is generally defined as an adult height of 4'10" or less.

Dwarfism Types

• Achondroplasia is caused by poor bone growth which results in short limbs and can be inherited or caused by a spontaneous mutation in the embryo.

• Growth hormone deficiency, or pituitary dwarfism, occurs when the body doesn't produce enough growth hormone, either at birth or later.

• Muscular dystrophy is a hereditary condition involving progressive muscle weakening and wasting.

Visual Impairment Spectrum

• Visual impairment is an umbrella term for total blindness and partial sight.
• Partial sight is visual impairment where someone can read print through large print or magnification.
• Blindness happens when someone is unable to read print even when magnified.
• Legal blindness is visual impairment with 1% or less visual acuity of a person with perfect vision (20/20), or a visual field of 20 degrees or less in both eyes.
• Travel vision is visual impairment where someone cannot see at 5-10 feet what a normal eye can see at 200 feet.
• Light perception is visual impairment when someone can distinguish strong light from 3 feet away, but cannot detect hand movement at that distance.
• Total blindness is the inability to recognize a strong light shining into the eyes.
• Albinism involves a lack of pigment which causes abnormal optic nerve development.
• Retinoblastoma is malignancy of the retina which requires removal of the eye.
• Retinopathy of prematurity (ROP) involves abnormal blood vessel growth through the retina; rupture of these vessels pulls the retina out of place, leading to retinal detachment and blindness.
• Cataracts is opacity of the lens which restricts light passage within the eye.
• Cortical visual impairment causes variable vision and visual ability changing day to day and minute to minute.
• Glaucoma occurs when increased pressure in the eye causes optic nerve damage.
• Macular degeneration involves progressive degeneration of the macula (central point of the retina).
• Retinitis pigmentosa involves a genetic defect affecting the retina's ability to sense light.

Auditory Impairment Spectrum

• Mild: inability to hear faint or quiet speech from approximately 5 feet away.
• Moderate: inability to hear normal speech from approximately 5 feet away.
• Moderate-severe: inability to hear loud speech from approximately 5 feet away.
• Severe: inability to hear extremely loud (yelling) speech from approximately 5 feet away.
• Profound: inability to hear extremely loud or inaudible speech from approximately 5 feet away.
• Deafness involves severe or profound hearing loss where hearing is insufficient for understanding auditory information with or without a hearing aid.
• Hard of hearing is a hearing loss that makes understanding speech through the ear alone difficult but not impossible.
• Conductive hearing loss happens when a mechanical problem means sound is not transmitted to the inner ear; there is no distortion, but words are faint.
• Sensorineural hearing loss involves damage to the inner ear and/or pathways to the brain which affects fidelity (distortion) and loudness.
• Mixed hearing loss is a combination of conductive and sensorineural hearing loss.

Neurological Impairment

• Traumatic brain injury is injury to the brain that's not hereditary, congenital, or degenerative, and occurs from impact to the brain (either open or closed).
• Ischemic stroke results from interrupted blood flow to the brain caused by a blood clot.
  • Thrombotic: clot forms in an artery within the brain.
  • Embolic: clot forms elsewhere in the body and travels to the brain via the bloodstream.
• Hemorrhagic stroke happens when there is uncontrolled bleeding in the brain.
• Transient ischemic attack is a short-term lack of blood supply to the brain, and is also known as a "mini-stroke".
• Spastic cerebral palsy involves stiff muscles restricting movement, with hypertonic and spastic muscle tone.
• Athetosic cerebral palsy is characterized by constant, unpredictable, purposeless movement caused by fluctuating muscle tone (hyper and hypo-tonic)
• Ataxic cerebral palsy includes a loss of balance and coordination with hypotonia and low postural tone.
• Multiple sclerosis is an autoimmune disease of the central nervous system with plaques or lesions developing on the white matter, preventing neuron signal transmission.
  • Relapsing-remitting involves a steady decline with superimposed attacks.
  • Secondary progressive initially relapsing-remitting and suddenly begins declines without remission periods.
  • Primary progressive causes a steady increase in disability without attacks.
  • Progressive relapsing involves unpredictable attacks with or without permanent deficits, followed by remission periods.

Intellectual Impairment

• Down syndrome is a developmental impairment from an additional 21st chromosome, resulting in 47 total chromosomes instead of 46.
• Fetal alcohol spectrum disorder is a developmental impairment from increased maternal alcohol consumption during pregnancy; characterized by delays in physical, cognitive, sensory, neurological, communicative, and social development.
• Global developmental delay is an umbrella term where general developmental delays in functioning exist but cannot be classified with a specific diagnosis; usually reserved for children under 5.

Neurodiversity

• Autism spectrum disorder is a developmental impairment in social interaction, communication, and restricted interests/behaviors, and is usually diagnosed by age 2.

Triad of Impairment for Autism

• Impaired social interaction includes things like failure to develop peer relationships, lack of spontaneous sharing, lack of social and emotional reciprocity, preference for solitary activities, being egocentric, difficulty developing/maintaining friendships, and difficulty adjusting to change.

• Communication deficits include deficits in nonverbal communication, abnormal eye contact/body language, lack of facial expressions, lack of spoken language, and abnormalities in pitch/rhythm.

• Repetitive behavior includes repetitive motor mannerisms, abnormal use of objects/speech, insistence on sameness, and restricted patterns of interest.

• Sensory issues include hyper or hypo-reactivity and indifference to pain/temperature.

• Attention Deficit Hyperactivity Disorder includes impulsivity, hyperactivity, inattention, and difficulty with task persistence.

• Dyspraxia, or developmental coordination disorder, involves difficulty with motor planning, coordination, balance, and fine/gross motor tasks.

• Dyslexia includes difficulties with reading, writing, memory retention, and information processing.

• Tourette's Syndrome involves involuntary motor/verbal tics, anxiety, and impulse control issues.

• Sensory Processing Disorder means having hyper or hypo-sensitivity to sensory input (touch, noise, light, movement).

Overview of physical impairments including surgical amputation, phacomelia, arthritis, osteoporosis, and dwarfism. Covers dwarfism types such as achondroplasia and growth hormone deficiency. Also touches on muscular dystrophy and its effects on muscle weakness.